   <%@ Page Language="C#" MasterPageFile="~/AdminForms/AdminHeaderFooter.master" AutoEventWireup="true"
    EnableViewState="true" CodeFile="frmAdmin_FacilitySetup.aspx.cs" Inherits="frmAdmin_FacilitySetup"
    Title="Untitled Page" %>

<asp:Content ID="Content1" ContentPlaceHolderID="adminheaderfooter" runat="Server">
  <%--  <form id="facilitysetup" method="post" runat="server" enableviewstate="true">--%>
  <div style="padding-top:110px;">
    <h3 class="margin">
        <asp:Label ID="lblForm" runat="server" Text="a"></asp:Label></h3>
    <div class="border center formbg">
        <table class="pad5 formbg" width="100%" border="0" cellpadding="0" cellspacing="6">
        <tr>
                <td class="border pad5 whitebg" valign="top" width="100%" colspan="2">
                    <table width="100%">
                        <tr>
                            <td align="right" style="width: 50%">
                                <label for="lblFacility_name">
                                    Facility/Satellite Name:</label>
                            </td>
                            <td>
                                <asp:TextBox ID="txtfacilityname" runat="server" MaxLength="50"></asp:TextBox>
                            </td>
                        </tr>
                    </table>
                </td>
                
            </tr>
            <tr>
                <td class="border pad5 whitebg" valign="top" width="50%">
                    <table width="100%">
                        <tr>
                            <td align="right" style="width: 50%">
                                <label for="lblFacility_name">
                                    National Id:</label>
                            </td>
                            <td>
                                <asp:TextBox ID="txtNationalId" runat="server" MaxLength="50"></asp:TextBox>
                            </td>
                        </tr>
                    </table>
                </td>
                <td class="border pad5 whitebg" valign="top" width="50%">
                    <table width="100%">
                        <tr>
                            <td align="right" style="width: 50%">
                                <label id="lblCountry" runat="server" for="lblcountry">
                                    Country number:</label>
                            </td>
                            <td>
                                <asp:TextBox ID="txtcountryno" MaxLength="4" runat="server">695</asp:TextBox>
                            </td>
                        </tr>
                    </table>
                </td>
            </tr>
            <tr>
                <td class="border pad5 whitebg" valign="top" width="50%">
                    <table width="100%">
                        <tr>
                            <td align="right" style="width: 50%">
                                <label id="lblPOS" runat="server" for="lblPOS">
                                    Facility number:</label>
                            </td>
                            <td>
                                <asp:TextBox ID="txtLPTF" MaxLength="5" runat="server">111</asp:TextBox>
                            </td>
                        </tr>
                    </table>
                </td>
                <td class="border pad5 whitebg" valign="top" width="50%">
                    <table width="100%">
                        <tr>
                            <td align="right" style="width: 50%">
                                <label id="lblSatellite" runat="server" for="lblsatellite">
                                    Satellite number:</label>
                            </td>
                            <td>
                                <asp:TextBox ID="txtSatelliteID" runat="server"></asp:TextBox>
                            </td>
                        </tr>
                    </table>
                </td>
            </tr>
            <tr>
                <td class="border pad5 whitebg" valign="top" width="50%">
                    <table width="100%">
                        <tr>
                            <td align="right" style="width: 50%">
                                <label id="Label1" runat="server" for="lblPOS">
                                    Province/State:</label>
                            </td>
                            <td>
                                <asp:DropDownList ID="ddlprovince" runat="server" Width="188px" >
                                </asp:DropDownList>
                            </td>
                        </tr>
                    </table>
                </td>
                <td class="border pad5 whitebg" valign="top" width="50%">
                    <table width="100%">
                        <tr>
                            <td align="right" style="width: 50%">
                                <label id="Label2" runat="server" for="lblsatellite">
                                    District:</label>
                            </td>
                            <td>
                                <asp:DropDownList ID="ddldistrict" runat="server" Width="188px" >
                                </asp:DropDownList>
                            </td>
                        </tr>
                    </table>
                </td>
            </tr>
            <tr>
                <td class="border pad5 whitebg" valign="top" width="50%" nowrap="nowrap">
                    <table width="100%">
                        <tr>
                            <td align="right" style="width: 50%">
                                <label for="lblimage">
                                    Facility login image:</label>
                            </td>
                            <td>
                                <input id="FileLoad" style="width: 210px" type="file" runat="server" />
                            </td>
                        </tr>
                    </table>
                </td>
                <td class="border pad5 whitebg" valign="top" width="50%">
                    <table width="100%">
                        <tr>
                            <td align="right" style="width: 50%">
                                <label for="lblSatellitenumber">
                                    Appointment grace period:</label>
                            </td>
                            <td>
                                <asp:TextBox ID="txtGrace" MaxLength="3" runat="server">00</asp:TextBox>
                            </td>
                        </tr>
                    </table>
                </td>
            </tr>
            <tr>
                <td class="border pad5 whitebg" valign="top" width="50%">
                    <table width="100%">
                        <tr>
                            <td style="width: 40%" align="right">
                                <label for="lblPEPFAR">
                                    PEPFAR funding start date:</label>
                            </td>
                            <td>
                                <asp:TextBox ID="txtPEPFAR_Fund" MaxLength="11" runat="server"></asp:TextBox>
                                <img onclick="w_displayDatePicker('<%= txtPEPFAR_Fund.ClientID %>');" height="22"
                                    alt="Date Helper" hspace="3" src="../images/cal_icon.gif" width="22" border="0"><span
                                        class="smallerlabel">(DD-MMM-YYYY)</span>
                            </td>
                        </tr>
                    </table>
                </td>
                <td class="border pad5 whitebg" valign="top" width="50%">
                    <table width="100%">
                        <tr>
                            <td align="right" style="width: 50%">
                                <asp:XmlDataSource ID="CurrencyDT" runat="server" DataFile="~/XMLFiles/Currency.xml">
                                </asp:XmlDataSource>
                                <label class="right" for="lblcurrency">
                                    Currency:
                                </label>
                            </td>
                            <td>
                                <asp:DropDownList ID="cmbCurrency" runat="server" Width="188px" DataSourceID="CurrencyDT"
                                    DataTextField="Name" DataValueField="Id">
                                </asp:DropDownList>
                            </td>
                        </tr>
                    </table>
                </td>
            </tr>
            <tr>
             <td class="border pad5 whitebg" valign="top" width="50%">
                      <table width="100%">
                        <tr>
                            <td align="right" style="width: 50%">
                                <label style="width: 100%" align="right">
                                    Preferred Location:</label>
                            </td>
                            <td align="left" style="width: 50%">
                                <input type="checkbox" id="chkPreferred" runat="server" />
                            </td>
                        </tr>
                    </table>
                </td>
              <td class="border pad5 whitebg" valign="top" width="50%">
                     <table width="100%">
                        <tr>
                            <td align="right" style="width: 50%">
                                <label style="width: 100%" align="right">
                                    Status:</label>
                            </td>
                            <td >
                                <asp:DropDownList ID="ddStatus" runat="server" Width="100px">
                                    <asp:ListItem Value="0">Active</asp:ListItem>
                                    <asp:ListItem Value="1">InActive</asp:ListItem>
                                </asp:DropDownList>
                            </td>
                        </tr>
                    </table>
                </td>
            </tr>
            <tr>
                 <td class="border pad5 whitebg" valign="top" width="50%">
                 <table width="100%">
                        <tr>
                            <td>
                               <div class="center whitebg" id="paperless"  runat="server">
                                  <label class="center">Paperless clinic:
                                    <input type="checkbox" id="chkPaperlessclinic" runat="server" /></label>
                               </div>      
                            </td>
                        </tr>
                     </table>
                   </td>
                   <td class="border center whitebg" style="width:50%">
                      <table width="100%">
                          <tr>
                             <td class="pad35">
                                 <div nowrap='nowrap' class="divBorder border left whitebg" align="left" id="PMTCTdiv" runat="server" width="1%">
                                     <asp:CheckBoxList ID="cblPMTCT" runat="server" RepeatLayout="Flow" width="70%">
                                     </asp:CheckBoxList>
                                 </div>
                            </td>
                        
                        </tr>
                    </table>
                  </td>
                 </tr> 
            <tr>
                <td class="center" colspan="2">
                    <asp:Button ID="btnSave" runat="server" Text="Save" OnClick="btnSave_Click" />
                    <asp:Button ID="btnCancel" runat="server" Text="Reset" />
                    <asp:Button ID="btnExit" runat="server" Text="Close" OnClick="btnExit_Click" />
                    <asp:Button ID="btnOk" Text="OK" CssClass="textstylehidden" runat="server" OnClick="btnOk_Click" />
                </td>
            </tr>
        </table>
    </div>
    <br />
    </div>
    <br />
</asp:Content>
